Morphea of the Breast with Presentation of Inflammatory Breast Cancer

Document Type : Case Report


1 Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Background and Objective: Bleeding from esophageal varicose (EV) is one of the lethal complications of liver cirrhosis. Upper gastro-intestinal endoscopy (UGIE) is performed in all cirrhotic patients for screening EV but recently some non-invasive methods have been evaluated as a substitute. For this purpose the aim of this study was to assess the correlation between EV and reno-vascular resistance index (RRI) in cirrhotic patients.
Subjects and Methods: Sixty four cirrhotic patients with normal renal function were included and underwent UGIE ‎and measuring RRI using color flow and pulsed wave Doppler ultrasonography. Correlation ‎ between the mean of RRI was evaluated with presence and grade of EV. P<0.05 was considered statistically significant.
Results: EV was detected in 42 patients (65.5%). The means of RRI were 0.68±0.03 versus 0.62±0.04 in patients with or without EV, respectively (P<0.001). Moreover, there was a significant statistically difference between the mean of RRI and size of EV (P=0.04). The cutoff points for prediction of EV were:  higher than 0.67, had sensitivity, specificity, positive and negative predictive values of 73.8, 72.7, 83.8 and72.8%, respectively. There was a positive association between the Child-Pugh class and presence of EV (P =0.038).  In contrast, no correlation between the Child-Pugh class and grade of EV was detected (P =0. 31).
Conclusion: These data suggest that the extent of RRI has strong correlation with the presence and degree of EV in cirrhotic patients. Consequently, RRI  may be consider as alternative non-invasive marker for screening EV specially in patients with Child-Pugh class A cirrhosis.

Morphea of the breast is an uncommon clinical disease and may have profound effects on the quality life of the patients. The disease can also mimic inflammatory benign and malignant diseases of the breast and differentiation between them is sometimes very difficult.
Herein, we report a case of morphea of the breast in a 28-year- old female with a history of skin changes of the right breast who referred to a general surgeon for possible diagnosis and treatment of the breast cancer. Diagnosis of the breast morphea with skin biopsy was proven after one year. We describe morphea of the breast and discuss our experience on the differentiation of the morphea of the breast with inflammatory breast cancer.